HCUP e-News: the electronic newsletter of the Healthcare Cost and Utilization Project



March 2010
Issue #22


Contents

News and Announcements: Information on happenings, including newly released databases and products
Recent Publications: A sample of materials, including peer-reviewed journal articles, utilizing HCUP data
Users´ Tech Tip: Answers to commonly asked questions when working with HCUP data
HCUP Calendar: Recent and upcoming conferences or meetings at which HCUP was/will be represented



NEWS AND ANNOUNCEMENTS

Pennsylvania Becomes the 42nd HCUP Partner

HCUP is pleased to welcome the Pennsylvania Health Care Cost Containment Council (PHC4) as the newest participating HCUP partner. Beginning with the 2008 data year, Pennsylvania will add its inpatient data to the Nationwide Inpatient Sample (NIS). This addition brings our total number of statewide data organizations to 42 partners, making the HCUP databases an even more powerful administrative data resource.

More 2008 State Databases Released

HCUP’s 2008 State-level databases, including the State Inpatient Databases (SID), State Ambulatory Surgery Databases (SASD), and State Emergency Department Databases (SEDD), are released on a monthly basis as processing is completed. Researchers and policymakers can use these State-specific databases to investigate questions unique to one State; compare data from two or more States; conduct market area research or small area variation analyses; and identify State-specific trends in utilization, access, quality, charges, and outcomes.

The following 2008 HCUP State databases are currently available:


Additional 2008 State databases will be released in the coming months. Available databases are listed on the HCUP Database and Product Release Calendar and in the SID/SASD/SEDD Application Kit. These State databases, as well as the national HCUP databases, are available for purchase through the HCUP Central Distributor. In addition, select State files can be accessed via HCUPnet.

Supplemental Files for Revisit Analyses Now Available for Select State Databases

The newly-released HCUP Supplemental Files for Revisit Analyses are discharge-level files designed to facilitate analyses to track patients across time and hospital settings in the SID, SASD, and SEDD.

Each record in an HCUP database represents one discharge abstract from a hospital setting (inpatient, emergency department, or ambulatory surgery) – meaning if an individual visited the hospital three times in a given year, the HCUP databases would include three separate records in the respective database. After being combined with the corresponding SID, SASD, or SEDD, the HCUP Supplemental Files for Revisit Analyses allows researchers to uniformly identify sequential visits for an individual and use the available clinical information to study if the visits are unrelated, complications from a previous treatment, or an unexpected revisit or re-hospitalization. Total charge information from each visit can be combined to determine the total charge or cost for an episode of hospital care.

HCUP Supplemental Files for Revisit Analyses are designed to be used exclusively with the HCUP State databases and are unique by State and data year. Users will need to merge the data elements on the HCUP Supplemental Files for Revisit Analyses to the corresponding SID, SASD, or SEDD for analysis.

Additional information regarding on the Supplemental Files for Revisit Analyses is available on the HCUP-US Website. The files are available free-of-charge from the HCUP Central Distributor.

Expand your Skill Set with the HCUP Online Tutorial Series

AHRQ is pleased to announce a new HCUP Online Tutorial Series. These online trainings are designed to provide data users with information about HCUP data and tools, as well as training on technical methods for conducting research with HCUP datasets.

The first technical course in the series, HCUP Sample Design Tutorial, has been released. This tutorial assists users in understanding the sampling strategy of the three nationwide databases: the Nationwide Inpatient Sample (NIS), the Kids’ Inpatient Database (KID), and the Nationwide Emergency Department Sample (NEDS).

Additional modules will be released later this year. Topics will include loading and checking HCUP data and producing national and regional estimates.

The HCUP Online Tutorial Series is available on the HCUP-US Website. For more information, please contact HCUP User Support at hcup@ahrq.gov.

New to HCUP-US: The Publications Search Page

The HCUP-US Website now features a page where users can search for HCUP Publications based on data year, database, and tools and products. The Publications Search page provides two methods of searching articles. The Simple Search option allows users to type in keywords and select from Peer-Reviewed Journals, Other Publications, or All Publications. The Advanced Search method allows users to search within specific fields, such as author, title, periodical, publication, abstract, State, data year, database, and HCUP tools and products.

To access the Publications Search page, please visit the HCUP-US Website.

Coming Soon! MONAHRQ: A Way to Input Your Data—Output Your Website

MONAHRQ (My Own Network – Powered by AHRQ), a downloadable desktop application AHRQ is developing to enable an organization to input its own hospital administrative data and generate a data-driven website, is near release. MONAHRQ analyzes, summarizes, and presents information on quality of care, preventable hospitalizations, rates of conditions and procedures, and health care utilization in a format ready for use by consumers and other decision-makers.

Any organization with hospital administrative data – such as State and local data organizations, chartered value exchanges, hospital systems, health plans, and providers – can use MONAHRQ to generate its own website for internal use or public release. Organizations will host the new site on their own web server and populate it with their own hospital administrative data. The website generated by MONAHRQ is an interactive querying tool that users can navigate to learn about health care in their area.

AHRQ anticipates publicly launching the tool soon. For more information, please contact MONAHRQ User Support at MONAHRQ@ahrq.gov, or visit the MONAHRQ section on the HCUP-US Website.

New HCUP Statistical Briefs Available on the HCUP-US Website

HCUP Statistical Briefs are short, focused reports on topics related to specific conditions, procedures, or populations. Statistical Briefs are useful to a wide variety of audiences, including policy analysts, decision-makers, media personnel, and others in need of summary facts and figures on current health care issues.

Recently-released Statistical Briefs include:

These and other HCUP Statistical Briefs can be found on the HCUP-US Website.

Registration for HCUP’s New Databases and Tools Webinar Series has Closed

HCUP’s new two-part Webinar series on HCUP databases, products, and tools quickly filled to capacity within days of being offered. Registration for both sessions is now closed.

The first one-hour session planned for Monday, April 12, will introduce health services and policy researchers to the HCUP databases and related resources to enhance their research studies by providing a general overview of the HCUP databases.

The second one-hour session taking place Monday, May 10, will focus on the HCUP products and tools. A particular emphasis of the Webinar will be on HCUPnet, our free online data query system.

Information on all HCUP events is located on the HCUP Calendar.

Join AHRQ for an HCUP Training Workshop this Spring

On April 26, AHRQ will sponsor a full-day hands-on workshop for health services researchers interested in using HCUP data resources. The course will be held at AHRQ Headquarters, located in Rockville, Maryland. Participants will be exposed to HCUP databases and related tools, including HCUPnet, through hands-on manipulation of the data, including file construction, producing national estimates, creating State-level output, and applying critical methods to produce correct standard deviations. Access to HCUP databases will also be provided during the workshop.

Registration for this event is open until April 15 or until the workshop reaches capacity. Based on previous workshop enrollments, capacity is reached prior to the registration deadline. Additional information for this event is located on the HCUP-US Website. We hope to see you there!

Keeping Up with HCUP: Recent Events

This winter, HCUP staff participated in the following event:

A complete list of HCUP events is available on the HCUP Calendar. Please contact HCUP User Support with questions. We have a number of events coming up this year and enjoy meeting HCUP users at our trainings, presentations, and exhibit booths. If you’ re in attendance, please say hello!


RECENT PUBLICATIONS

Rivard PE, Elixhauser A, Christiansen CL, Zhao S, Rosen AK. Testing the Association Between Patient Safety Indicators and Hospital Structural Characteristics in VA and Nonfederal Hospitals. Medical Care Research and Review. 2009 Oct 30.

This analysis used the 2003 Nationwide Inpatient Sample (NIS) and AHRQ Patient Safety Indicators (PSIs) to test the association between hospital structural characteristics (such as teaching status, bedsize, and nurse staffing) and potentially preventable adverse events. The research found there was no association between the structural characteristics and the likelihood of patient safety events for most PSIs; however, some unfavorable associations occurred between major teaching hospital status and six of the PSIs analyzed. The article abstract is available via Pubmed.

Ma L, El Khoury AC, Itzler RF. The Burden of Rotavirus Hospitalizations among Medicaid and non-Medicaid Children Younger than 5 Years Old. American Journal of Public Health. 2009 Oct;99 Suppl 2:S398-404.

This analysis used the 2000 and 2003 Kids’ Inpatient Database (KID) to compare the burden of hospitalizations associated with rotavirus gastroenteritis (RGE) in children younger than five years in U.S. Medicaid and non-Medicaid populations. Though approximately 40 percent of the total U.S. population under the age of five was enrolled in the program, the research found that children under the age of five who were enrolled in Medicaid accounted for 50 percent of RGE hospitalizations. Hospital rates, average lengths of stay, and average charge per stay were also larger for children enrolled in Medicaid than those in the non-Medicaid population. The article abstract is available via Pubmed.

To read additional recently-published articles featuring HCUP data, please visit the Research Spotlights page on the HCUP-US Website.

USERS’ TECH TIP

Adding Clinical Data Methods Report

The latest addition to the HCUP Methods Series discusses the main findings from AHRQ’ s recently-completed Adding Clinical Data project, which took place from September 2007 through October 2009.

Administrative data include information on diagnoses and procedures, but lack more detailed, clinically important variables that could be useful in efforts to improve health care quality (e.g., physiological data, including lab values and vital signs, that allow for accurate measurement of illness severity). Additionally, administrative data may not include present on admission (POA) indicators for diagnoses, which distinguish between conditions that are present at admission and those arising during hospital stays, such as hospital-acquired infections or post-admission heart attack.

Through a Request for Proposal process, contracts were awarded to three HCUP Partners (Florida Agency for Health Care Administration, Minnesota Hospital Association, and Virginia Health Information), to conduct in-depth pilot projects to add or link hospital clinical information to administrative data. One planning contract was awarded to a Partner (Washington Department of Health) seeking to enhance its current collection with more clinical data but not yet ready to engage in a pilot. The variations in approach, processes, and tools from the sites – which represented a state agency, a hospital association, and private data organizations – demonstrated that each type of Partner can successfully undertake a project of this nature.

Lessons learned by the Partners fell under three categories: project initiation, data standards and transmission, and communicating with hospital and stakeholders.

Project initiation

Each Partner organization initiated their project and developed plans to engage hospitals in the collection of clinical data and POA. Lessons learned included:

Data standards and transmission

All three pilot projects found that use of data standards (LOINC and HL7) was not widespread. This project was cutting edge in the use of LOINC standards for lab data. Other findings included:

Communicating with hospitals and other stakeholders

The pilot organizations determined that frequent, detailed communication and flexibility was fundamental to the success of the project. Additional lessons included:

AHRQ is committed to assisting HCUP Partners in adding clinical data to their administrative datasets. The next phase of the project includes developing a toolkit of material for statewide data organizations to use when approaching adding clinical elements to their data streams.

The complete report, Enhancing Clinical Information in Statewide Hospital Administrative Data: Project Summary and Lessons Learned (Report #2010-01) can be downloaded from the HCUP Methods Series Web page. For more information on the Adding Clinical Data project, please visit the project page on the HCUP-US Website.

HCUP CALENDAR

April 12, 2010: HCUP Webinar: Overview of HCUP Databases – Registration has Closed

AHRQ will host the first of a two-part Webinar series on the HCUP databases, products, and tools on Monday, April 12, from 2:00-3:00 PM EST. This one-hour session will introduce health services and policy researchers to the HCUP databases and related resources that can enhance their research studies by providing a general overview of the data sets. Additional information is located on the HCUP-US Website.

April 26, 2010: HCUP Data Users Workshop, Rockville, MD

AHRQ will sponsor a full-day hands-on workshop at AHRQ Headquarters for health services researchers interested in using HCUP data resources. Participants will be exposed to HCUP databases and related tools (including HCUPnet) via hands-on manipulation of the data. Additional information will be available prior to the event. Registration will be required; information is available on the HCUP-US Website.

May 10, 2010: HCUP Webinar: Overview of the HCUP Products and Tools – Registration has Closed

AHRQ will host the second of a two-part Webinar series on the HCUP databases, products, and tools on Monday, May 10, from 2:00-3:00 PM EST. This one-hour session will introduce health services and policy researchers to the HCUP products and tools, with particular emphasis on HCUPnet, our free online data query system. Additional information is located on the HCUP-US Website.

May 15-19, 2010: International Society for Pharmacoeconomics and Outcomes Research (ISPOR) 15th Annual International Meeting, Atlanta, GA

AHRQ staff will present an HCUP case-study presentation entitled "New Findings from Integrating Administrative and Financial Databases to Estimate Price of Hospitalizations" during ISPOR’ s 2010 Annual Conference on Tuesday, May 18, from 9:45-10:45 AM. Also on May 18, AHRQ will present a poster entitled "Procedures with the Most Rapidly Increasing Hospital Costs, 2004-2007". HCUP will additionally sponsor an exhibit booth throughout the meeting. Representatives will be available to provide information and answer questions.  Additional meeting information is available on the ISPOR Website.

May 27, 2010: 2010 Annual Emergency Medical Services for Children (EMSC) Program Meeting, Bethesda, MD

AHRQ will host a 90-minute session from 9:00-10:30 AM to provide an overview of HCUP, specializing on how it relates to pediatric emergency medicine research interests. The session will also include a demonstration of HCUPnet, the free, online query system that provides instant access to national, regional, and state-level hospital inpatient statistics based on HCUP data, with time allocated to address participant questions. Additional meeting information is available on the EMSC Website.

June 6-10, 2010: Council of State and Territorial Epidemiologists (CSTE) Annual Conference, Portland, OR

HCUP will sponsor an exhibit booth during the CSTE Meeting, to be held at the Oregon Convention Center. Representatives will be available to provide information and answer questions. Additional conference information is available on the CSTE Website.

June 27-29, 2010: AcademyHealth Annual Research Meeting, Boston, MA

HCUP staff will provide an in-depth, 90-minute introduction to the HCUP databases and related products. Information on registration and presentation topics will be available later this spring. A booth will also be sponsored during this event. Additional conference information is available on the AcademyHealth Website.

July 22-25, 2010: American Association of Pediatrics (AAP) Pediatric Hospital Medicine Conference 2010, Minneapolis, MN

HCUP will sponsor an exhibit booth during the AAP Pediatric Hospital Medicine Conference, to be held at the Hyatt Regency Minneapolis. Representatives will be available to provide information and answer questions. Additional conference information is available on the AAP Website.

For a complete list of HCUP presentations and events, visit the HCUP Events Calendar, located on the HCUP-US Website.

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